Appendix A - Hertfordshire Mapping of ASD Service provision
Refer on to
Interventions
Criteria
Referrers
Hertfordshire Community
NHS Trust (HCT)
Hertfordshire County
Council
Hertfordshire County
Council
East & North
Hertfordshire NHS Trust
Hertfordshire Community
NHS Trust
 Challenging Behaviour
 Children’s Social Care
Psychology Service (CBPS)
being re-commissioned
2014
 ISL
 Community Paediatricians
 Part time Psychologists
 Specialist HV – East &
North Hertfordshire
 Community Paediatricians
(West Herts)
 Specific Health
Professionals including
 Child Development Centre
Professionals
 CAMHS - tier 3 and 4
 Tertiary Centres
 Professionals
 Carers/Parents
 Any person who has some
relationship with Child or
Family
 Referred through
Customer Services Desk
and single service request
form
 If universal and targeted
service unable to meet
need
 Safeguarding referrals
regarding CYP with ASD
will be picked up by
Disabled Children's Team
 0-18yrs
 Team around the child
 Health Professionals
 SENCO
 Social Worker
 School
 Health Professionals
 Health Professionals
 Pre-school Children
without ASD diagnosis
considered by intake
panel who determine
team and support
 Must have Autism
Diagnosis for the
Communication Disorder
Team - intervention and
type determined by
Intake panel
 Up to 16 years old
mainstream
 Up to 19 if in special
school,
GP in East and North
Herts (exception for those
who attend special school
)
 Some evidence of autism
or other developmental
disorders
 Up to 16 years old
mainstream;
 Up to 19 if in special
school,
 GP in West Herts for
Community Paediatricians
 Some evidence of autism
or other developmental
disorders
 Social Work assessment key worker to coordinate
services
 Child in need meetings
 Provision of respite/
equipment/
ongoing package of care
to support in home or
foster care
 level of intervention/
package dependent on
need
 Training for school and
Parents
 Home visiting service
 Weekly Support Groups
 Evidenced Based advice on
strategies and
interventions.
 Systemic support
Assessments
 Cognitive assessments (Ed
Psych)
 Diagnostic pathway and
assessments
 Do joint assessments with
SALT and school
 Create a profile of
strengths and
difficulties/needs and a
care plan even if no
diagnosis
 Follow up in clinics
 Diagnostic assessments
dependent on need
 Provide therapy services
around Occupational
Therapy incl. sensory
profiling/ Speech and
Language/ challenging
behaviour service
 Medical management
including medication
 CAMHS
 CBPS
 LD Psych service
 Angels
 Stop Gap
 HV (behaviour
management)
CPBS Challenging
Behaviour
Autism Advisory Service;
over 5 years need a
diagnosis to access
CAMHS
 Diagnosis of ASD and/or
Learning Disability and
challenging behaviour
 0 – 16 years or 19 years if
in specialist education
 Evidence of appropriate
community service
attempted
 Registered with GP in
Hertfordshire
 Seen and assessed by
referrer
 Family Consent to referral
 Assessment of Challenging
Behaviour including
extended assessment/
functional analysis
 Direct interventions short
and long term
 Direct work with
Parent/Carer/
Professionals
 Consultation to
Parent/Carer/
Professionals
 Training to Parent/
Carer/Professionals
 Joint Work with CAMHS if
indicated
 CS – Disabled Children’s
Team
 CS OT
 Specialist CAMHS
 Vol. sector – KIDS HUB
 Scaffold SALT
 Young Carers
 Parent Partnership
 CAMHS
 Challenging Behaviour
Psychology Service
 Step 2 (Tier 2 CAMHS
provided by HCT)
 Adult Care Services
These services are
provided by a number of
teams including:
 Early Years SEND
Communication,
Disorders Team (prev
called Autism Advisory
Service), Education
Psychology, Behaviour &
Attendance
 Parent Support Groups
 CBPS
 CAMHS
Discharge/
Handover
Back to referrer or to
other services as indicated
above.
Hertfordshire
County Council
(HCC)
Interventions
Criteria
Referrers
 Adult
Very few discharged and if
they are, then this is
handed over to universal
services or Adult Care
Services (transition team).
Closed when service no
longer needed by the
school (but can re-refer if
needed).
Hertfordshire Community NHS Trust (HCT)
 OT & SLT
 Health
Professionals
 Call Centre
 Children’s
Services
 Stop-Gap
 Connexions
 Probation
 Parents
 Paediatricians
 GPs
 Health visitors
 Schools
 Advisory services
 Educational psychologists & other educational
professionals
 Occupational therapy
 Physiotherapy
 CBPS and Tertiary Centres
 HCT health professionals
 Children’s services
OT
 Fair Access to
 Referrals accepted according to presenting
Care
problems, not diagnosis; diagnosis not
 Resident of
recorded as primary reason for referral
Hertfordshire
 Registered with Herts GP
 18 yrs +
SLT
 Transitions team IQ 70 and under  Age 0-16 (in new specification 0-18); also 1619 for those young people who have a
statement of their SEN attending Herts
schools
 Service operates across Herts
 Clinical guidelines based on developmental
speech, language and communication norms
OT
 Adults with
Asperger’s Social  Sensory workshops: advice to parents & schools on
strategies to develop sensory & motor skills;
Care Team
treatment to address motor difficulties; may include
 Individual budgets
the use of sensory integration principles.
/ service
SLT
 Benefits guidance  Functional communication assessments: Formal
assessment as appropriate; parent workshops;
 Person centred
makatron signing training
support plan
 Integrated intervention & support programmes to
 Promoting using
the educational setting linking functional level of
mainstream
communication with national curriculum levels
services
 1-2-1/group work in most effective environment
 Learning Disability  Training for families & staff on specific approaches,
services for those
e.g. Picture Exchange Communication System (PECS)
with IQ less than
Social Stories
 Elklan training for schools: support in classroom,
70
Once they have a
diagnosis, back to referrer
or to other services
indicated above.
Hertfordshire Partnership Foundation Trust
(HPFT)
Refer on to
 CAMHS
 LD Psych Service
 Angels
 Stop Gap
 HV (behaviour management)
 CPBS Challenging Behaviour
 Autism Advisory Service (over 5s need a
diagnosis to access)
Hertfordshire
Partnership Foundation
Trust (HPFT)
 CAMHS
 Adult
 Health Professional/ Social Worker if key
worker lead professional for TAF
 Educational Psychologist
 CBPS (for tier 4 - only consultant
paediatrician/ tier 3 CAMHS, CBPS)
 Single Point of Access
(SPA) Health
Professionals
 Call Centre (self or
family)
 Children’s Services
 Stop-Gap
 Connexions
 Probation
 Up to 18yrs and up to 19 if in special school
 GP in Hertfordshire
 CYP has severe, complex &/or persistent
difficulties presenting as emotional/
behavioural symptoms
 Appropriate Community service has been
tried
 Very severe presentation e.g. psychosis, risk
of suicide, eating disorders
 CYP has been seen by referrer and family
agree to referral
 Tier 4 - only if consultant paediatrician/ tier
3 CAMHS, CBPS accepts referral
 Diagnostic assessments - Primary; Second
Opinion and Co-Morbid
 Art therapy
 Speech and Language
 Occupational therapy
 Psychiatric assessment
 Cognitive and scholastic
 Socio-emotional functioning
 Mental health
 Emotional well being
 Medication
 Bespoke cognitive behavioural therapy
 Family therapy/interventions
 18 - 65 yrs
 Hertfordshire
Partnership Foundation
Trust (HPFT) Catchment
area
 Mental health difficulty/
meet ‘Asperger-friendly’
FAC criteria
 Impaired functioning in
activities of daily living
 IQ over 70
complex needs.
 Day Opportunities
 Work solutions
 Accommodation
Solutions
 Signposting to
voluntary groups/
services
Back to referrer or to
other services indicated
above.
 Challenging Behaviour Psychology Service
 Paediatricians
 Tertiary commissioning including Great
Ormond Street and The Maudsley
 ADDVANCE
 Autism Advisory Service
 Children’s Services
 Adult Mental Health Services (transition
starts at 17½)
 Diagnostic assessments
 Fair Access to Care
Assessments
 Psycho-educational
package to parents
 Psychologically informed
interventions
 Acer’s assessments for
carers
 Allocation of a care
coordinator - assess for
personal budget or act
as advocate.
 Supervising/
consulting to other
organisations
 NAS
 Work Solutions
 Vision
 Turning Point
 MIND
 Viewpoint
 Crossroads
 Guidepost
 Trust
 Living Autism
Discharge/
Handover
May be
transferred to
Third Sector
Providers.
Likely to require
varied levels of
support from
services through
life.
OT: If targets are met or the child and family have
strategies to manage their condition
Move out of area
SLT: Children are discharged once they develop
functional communication skills commensurate with
their overall abilities; adults are able to provide
appropriate support by becoming more aware of the
child’s communication skills and have an
understanding of how they can adapt to maximise
functional communication in everyday situations
Back to referrer or to other services as
indicated above.
Back to referrer or to
other services indicated
above.
When Personal budget
not needed.
Does not meet FAC
criteria.